The Quality of Trabecular Bone Tissue in Women with Rheumatoid Arthritis

V.V. Povoroznyuk, T.A. Karasevska, N.I. Dzerovych


The article deals with the study of the quality index of trabecular bone tissue in patients with rheumatoid arthritis (RA). The study included 134 female patients with RA aged 31 to 78 years (mean age — 52.4 ± 12.7 years; height — 162.6 ± 6.4 cm; weight — 68.5 ± 13.8 kg; average duration of disease — 9.1 ± 7.6 years). In studying the effect of age on the structural and functional state of bone tissue, the examined patients were divided into five groups by decades. In order to evaluate the effect of glucocorticoids (GC) on the parameter of quality of trabecular bone and bone mineral density (BMD), the patients were divided into three groups: 1st group comprised 37 patients who did not take GC, 2nd group — 47 patients who had been prescribed with GC only at exacerbation, of the short, less than 6 months term, 3rd group — 50 patients who received systemically GC at a dose of ≥ 5 mg by prednisone for over 3 years. By the method of dual energy X-ray densitometry (Prodigy, GE Lunar, Madison, USA) we measured BMD at the lumbar spine, proximal femoral and radial bone. The index of the quality of trabecular bone tissue (TBS) of the lumbar spine was determined using the method of TBS iNsight (Med-Imaps, Pessac, France). It is established that starting from the age of 50 years, the indices of TBS L1-L4 (1.156 ± 0.140 vs. 1.318 ± 0.155 in women aged 30–39 years; t = 3.5; p = 0.001) and BMD of different parts of the skeleton in women with RA are significantly decreasing. GC administration is associated with the violation of the quality of the bone tissue. It was revealed that at the systemic administration of GC (in the 3rd group compared to the 1st group), rate of TBS L1-L4 (1.147 ± 0.168 vs 1.250 ± 0.135; t = –3.07; p = 0.003) was significantly lower, while significant changes in BMD parameters of the lumbar spine and femur hadn’t been detected. Over the year of follow-up the index TBS L1-L4 in 1st group decreased by 1.4 %, in 3rd group — by 5.8 %. Thus, the definition of TBS L1-L4 is a technique that can assess the impact of GC on bone tissue and dynamics of its loss as a result of treatment.


bone tossue quality (TBS L1-L4); rheumatoid arthritis; glucocorticoids; bone mineral density; osteoporosis


Поворознюк В.В., Нейко Є.М., Головач І.Ю. Глюкортикоїд-індукований остеопороз. — К.: ТМК, 2000. — 206 c.

Поворознюк В.В., Дзерович Н.И. Качество трабекулярной костной ткани у женщин различного возраста // Боль. Суставы. Позвоночник. — 2011. — № 4. — С. 29-31.

Поворознюк В.В., Дзерович Н.И. Качество трабекулярной костной ткани у женщин в зависимости от длительности постменопаузального периода // Боль. Суставы. Позвоночник. — 2012. — № 2. — С. 11-15.

Структурно-функціональний стан кісткової тканини в жінок різного віку, хворих на ревматоїдний артрит: Автореф. дис… канд. мед. наук: спец. 14.01.12 «ревматологія» / Карасевська Т.А. — К., 2010. — 16 с.

Bousson V., Bergot C., Sutter B. et al. Trabecular bone score (TBS): available knowledge, clinical relevance, and future prospects // Osteoporos Int. — 2012. — № 23(5). — Р. 1489-501.

Boutroy S., Hans D., Sornay-Rendu E. et al. Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study // Osteoporos. Int. — 2013. — № 24(1). — Р. 77-85.

Bréban S., Briot K., Kolta S. et. аl. Identification of rheumatoid arthritis patients with vertebral fractures using bone mineral density and trabecular bone score // J. Clin. Densitom. — 2012. — № 15(3). — Р. 260-6.

Chappard D., Legrand E., Basle M.F. et al. Altered trabe­cular architecture induced by corticosteroids: a bone histomorphometric study // J. Bone Miner. Res. — 1996. — № 11. — Р. 676-685.

Hans D., Goertzen A.L., Krieg M.A., Leslie W.D. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study // J. Bone Miner. Res. — 2011. — № 26. — Р. 2762-2769.

Haugeberg G., Uhlig T., Falch J.A., et al. Bone mine­ral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County Rheumatoid Arthritis register // Arthritis. Rheum. — 2000. — № 43. — Р. 522-530.

Koumakis E., Avouac J., Toth E. et al. Bone mineral density and microarchitecture assessment by trabecular bone score at the spine in patients with rheumatoid arthritis and systemic sclerosis //

Krieg M.A., Aubry-Rozier B., Hans D., Leslie W.D. Effects of anti-resorptive agents on trabecular bone score (TBS) in older women // Osteoporosis International March. — 2013. — № 24(3). — Р. 1073-1078.

El Maghraoui A., Rezqi A., Mounach A., et al. Prevalence and risk factors of vertebral fractures in women with rheumatoid arthritis using vertebral fracture assessment // Rheumatology. — 2010. — № 49. — Р. 1303-1310.

Orstavik R.E., Haugeberg G., Mowinckel А., et al. Vertebral deformities in rheumatoid arthritis: a comparison with populationbased controls // Arch. Intern. Med. — 2004. — № 164. — Р. 420-425.

Rabier B., Heraud A., Grand-Lenoir C. et al. A multicentre, retrospective case-control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): analysing the odds of vertebral fracture // Bone. — 2010. — № 46. — Р. 176-181.

Roux C. Osteoporosis in inflammatory joint diseases // Osteoporos. Int. — 2011. — № 22. — Р. 421-433.

Sinigaglia L., Nervetti A., Mela Q., et al. A multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis // J. Rheumatol. — 2000. — № 27. — Р. 2582-2589.

Tatsuno I., Sugiyama T., Suzuki S. et al. Age Dependence of Early Symptomatic Vertebral Fracture with High-Dose Glucocorticoid Treatment for Collagen Vascular Diseases // The Journal of Clinical Endocrinology & Metabolism. — 2009. — № 94(5). — Р. 1671-1677.

Weinstein R.S. Is long-term glucocorticoid therapy associated with a high prevalence of asymptomatic vertebral fractures? // Nat. Clin. Pract. Endocrinol. Metab. — 2007. — № 3(2). — Р. 86-87.

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